Form Pit-X - New Mexico Personal Income Tax - 2012
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1
22012 PIT-X
NEW MEXICO PERSONAL INCOME TAX
*120160200*
For the year January 1 - December 31, 2012
or fiscal year beginning
ending
F.1
F.2
If taxpayer or spouse died
Residency
SOCIAL SECURITY NUMBER
before this return is filed,
Blind
Over 65
status
Enter date of death.
Print your name (first, middle, last)
1a
1b
1c
1d
1e
1f
Print your spouse's name (first, middle, last) Include spouse if married filing separately.
2a
2b
2c
2d
2e
2f
Residency status: Complete
4.
If a deceased taxpayer's refund must be made payable to a person
for each taxpayer. Enter
3a
Check this box if the address is new or changed.
other than the taxpayer or spouse named on this return, enter the
"R" if RESIDENT;
name and SSN of that person.
3b
Mailing Address
You must also attach Form RPD-41083.
"N" if NON-RESIDENT;
"F" if FIRST-YEAR RES.,
4a Name
"P" if PART-YEAR RES..
City, State and ZIP Code
4b SSN
EXEMPTIONS - Number of Qualified Exemptions.
7. FILING STATUS - Check only one box below.
5.
If you are a dependent of another taxpayer, enter 00.
(1) Single
EXTENSION OF TIME TO FILE -
6a
6b
If you have a federal or state extension,
(2) Married filing jointly
check the box and enter the extension date.
8. DEPENDENTS: As listed on your federal return
(You must report the first 5 dependents in the table below and additional dependents on Schedule PIT-S)
(3) Married filing separately
(Enter spouse's social
security number above)
Column 1.
Column 2.
Column 3.
First name
Last name
Date of birth (MM/DD/YYYY)
Dependent's SSN
(4) Head of household
/
/
(Enter name of person
qualifying you as head of household if that person is not
/
/
counted as a qualified exemption on your federal return.)
/
/
/
/
(5) Qualifying widow(er) with dependent child
/
/
AS PREVIOUSLY FILED
AS AMENDED
9.
FEDERAL ADJUSTED GROSS INCOME
9
(From federal Form 1040, line 38; Form 1040A, line 22 or Form 1040EZ, line 4.) ......................
10. If you itemized your federal deduction amount, enter the amount of state and local tax
10
deduction claimed on line 5, federal Form 1040, Schedule A. ...................................................
11. Additions to federal income (Line 5 of PIT-ADJ; attach PIT-ADJ)...............................................
11
12. Federal standard or itemized deduction amount
(From federal Form 1040, line 40; Form 1040A, line 24; or Form 1040EZ, line 5.) ...................
12
12a. Check the box if you itemized. You must also complete line 7 if applicable..........
12a
13. Federal exemption amount (From federal Form 1040, line 42; Form 1040A,
13
line 26; or leave blank if you filed Form 1040EZ.).........................................................................
14
14. New Mexico low- and middle-income tax exemption (See PIT-1 instructions.)..........................
15. Deductions/Exemptions from federal income (Line 21 of PIT-ADJ; attach PIT-ADJ) .................
15
16. Medical care expense deduction (See PIT-1 instructions.)..........................................................
16
(You must complete both lines 16 and 16a or the deduction will be denied.)
16a
16a. Unreimbursed and uncompensated medical care expenses...
17.
NEW MEXICO TAXABLE INCOME
.......................
(Add lines 9, 10 and 11, then subtract lines 12, 13, 14, 15 and 16)
17
(Cannot be less than zero.)
18. Tax on amount on line 17 .............................................................................................................
18
18a
18a. If from the Rate Table, enter "R", If from line 14 of PIT-B, enter "B"......................
19. Additional amount for tax on lump-sum distributions (See PIT-1 instructions).............................
19
20. Credit for taxes paid to another state. You must have been a New Mexico resident during
20
all or part of the year. (See PIT-1 instructions. Include a copy of other state's return.) ..........
21
21. Non-refundable credits from Schedule PIT-CR (Line 21 of PIT-CR; attach PIT-CR) ..................
22
22.
NET NEW MEXICO INCOME TAX
(Add lines 18 and 19 then subtract lines 20 and 21) ...........
(Cannot be less than zero.)
Continue on the next page
.
Amended returns may be electronically filed through the Department's web site.
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